Assessment of adipokine and inflammation biomarkers with cancer risk among Chinese men: A prospective cohort study

Background: Obesity and chronic inflammation are associated with cancer risk. We investigated the association between adipokines, inflammation markers, and cancer risk among Chinese men. Methods: Using pre-diagnosis fasting plasma samples from 4,051 (6.6%) participants of the Shanghai Men’s Health Study, aged 40-74 during 2002-2006, we evaluated the associations of inflammation biomarkers with risk of all cancers and top four cancers among Chinese men, lung, stomach, liver, and colorectal cancer (CRC). Levels of leptin, resistin, adiponectin, plasminogen activator inhibitor type-1 (PAI-1), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 Beta (IL-1β), tumor necrosis factor-alpha (TNFα), monocyte chemoattractant protein-1 (MCP-1), and insulin were measured by Luminex assays, and C-reactive protein (CRP) by ACE Clinical Chemistry System. Cox regression models were applied to derive adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for cancer risk in association with per-log-unit and tertile increment of biomarker levels. Results: After adjusting for known cancer risk factors, the 3rd vs 1st tertile of TNFα (aHR=1.78, 95%CI=1.04-3.05) was associated with lung cancer, while leptin (aHR=3.00, 95%CI=1.23-7.25), insulin (aHR=2.26, 95%CI=1.04-4.54), and CRP (aHR=2.24, 95%CI=1.16-4.32) levels were each associated with CRC. Per-log-unit increase of TNFα was associated with all cancers (aHR=1.23, 95%CI=1.00-1.52) and lung cancer (aHR=1.45, 95%CI=1.00-2.15); insulin (aHR=1.46, 95%CI=1.04-2.05) and CRP (aHR=1.20, 95%CI=1.00-1.44) with CRC; and adiponectin (aHR=3.27, 95%CI=1.64-6.52), insulin (aHR=1.86, 95%CI=1.03-3.38), and IL-8 (aHR=1.81, 95%CI=1.00-3.30) with liver cancer. Conclusions: Pre-diagnostic plasma level of TNFα was associated with lung cancer; CRP, insulin, and leptin were associated with CRC. Impact: Inflammation and obesity biomarkers can identify high-risk individuals for targeted interventions.